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This form is used for participants in the Veterans History Project to grant permission for their audio- and video-taped oral histories and related materials to be collected and used by the Library

How to fill out veterans release form

How to fill out Veteran’s Release Form

1. Obtain the Veteran’s Release Form from the relevant authority or website.
2. Fill in the veteran's personal information, including name, date of birth, and Social Security number.
3. Provide the details of the medical or service records requested.
4. Sign the form to authorize the release of information.
5. Include the date of signing the form.
6. Review all entered information for accuracy before submission.
7. Submit the completed form to the appropriate department, agency, or organization.

Who needs Veteran’s Release Form?

1. Veterans seeking access to their personal service or medical records.
2. Family members of veterans who require information on behalf of the veteran.
3. Organizations assisting veterans with applications for benefits or claims.

People Also Ask about

What is VA form 4142 used for?

What form is used when turning in excess furniture or equipment? Excess is processed via VA Form 2237 (Request, Turn-In and Receipt for Property or Services) which can be found on VA Forms.

What is the difference between 4142 and 4142a?

While the VA has direct access to medical records from VA facilities, it does not automatically retrieve records from private doctors, specialists, or hospitals. That's where VA Forms 21-4142 (Authorization to Disclose Information) and 21-4142a (General Release for Medical Provider Information) come into play.

Why is the VA asking me to verify my dependents?

PENALTY: The law provides severe penalties which include fine or imprisonment, or both, for the willful submission of any statement or evidence of material fact knowing it to be false. If you do not revoke this authorization, it will automatically expire in 12 months from the date you sign and date the form.

What is a VA form 2237 used for?

Use VA Form 119, Report of Contact, to document all information received by telephone. ​ identify himself/herself to the caller as a VA employee who is authorized to receive the information or statement. ​ inform the caller that the information will be used for the purpose of calculating benefit amounts.

What is a VA form 4142?

Authorization to disclose information to the Department of Veterans Affairs (VA) (VA Forms 21-4142 and 21-4142a) Complete this form if you want to give us permission to request your records from a non-VA source to support your benefit claim.

Where can I download VA forms?

Use VA Form 21-4142 to give us permission to obtain your personal information from a non-VA source like a private doctor or hospital. Examples of personal information may include your medical treatment, hospitalizations, psychotherapy, or outpatient care.

For pdfFiller’s FAQs

What is Veteran’s Release Form?

The Veteran’s Release Form is a document used to authorize the release of an individual's military records to designated parties, such as employers or other institutions.

Who is required to file Veteran’s Release Form?

Veterans or active-duty military members who wish to allow access to their personal military records are required to file the Veteran’s Release Form.

How to fill out Veteran’s Release Form?

To fill out the Veteran’s Release Form, individuals need to provide their personal identification information, specify the records being requested, and sign the form to authorize the release.

What is the purpose of Veteran’s Release Form?

The purpose of the Veteran’s Release Form is to grant permission for the disclosure of military service records to specified individuals or organizations, ensuring that the privacy of the veteran is respected.

What information must be reported on Veteran’s Release Form?

The information that must be reported on the Veteran’s Release Form includes the veteran's name, Social Security number, contact information, details of the records requested, and the name of the recipient who will receive the records.